Porokeratosis are very similar to intractable plantar keratosis, however, the cause of porokeratosis have yet to be determined. Porokeratosis are not associated with any particular type bony prominence, structure in the foot, or virus. They look much like IPK’s but they can occur anywhere on the bottom of the foot. There is a core with surrounding thickened skin. There is no black dot present as there is in plantar warts. Some doctors believe porokeratosis are related to foreign bodies that have penetrated into the dermis of the skin causing the skin to produce a protective deposit of skin. Porokeratosis can appear as a single lesion or multiple lesions over any part of the foot on the plantar or bottom of the foot. People describe the discomfort as if there were several pebbles stuck to the bottom of their foot or in their shoe. Porokeratosis can become very painful over time depending on the location. Several different treatments have been attempted over the years including injections into the base of the lesions with dehydrogenated alcohol, debridements, and exfoliating agents. Debridement can be painful, but often gives immediate relief when done correctly. In order to debride porokeratosis correctly, it is important that the core of the lesion is removed. Using a pumice stone or other abrasive material only removes the outer surface not the core. Minimal relief is achieved from this type of debridement.